Læknablaðið - 01.06.2018, Blaðsíða 15

LÆKNAblaðið 2018/104 287
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Sif Ormarsdóttir1
Páll Helgi Möller1,2
Alma Rut Óskarsdóttir2
Pétur Hannesson1
Arthur Löve1
Haraldur Briem3
Aim
The incidence of hepatitis A (HAV) in Iceland is low with
about one case per year in the last decades. Since 2016,
there has been an ongoing outbreak of HAV in men who
have sex with men (MSM). The aim of this study was to
inves tigate whether cases diagnosed in Iceland during 2017
had any link to the HAV outbreak in Europe.
Methods
All cases of HAV in Iceland during 2017 were reviewed retro-
spectively.
Results
Four of five cases diagnosed during 2017 were MSM and
one was a female. Three cases presented the same week in
the summer 2017. The age of the patients was between 25
and 39 years. All the male patients had had sex with men
from Europe and/or had travelled to Europe prior to admis-
sion. All cases had typical signs and symptoms of HAV
infection and in all cases recent infection was confirmed
by positive serology and exclusion of other causes of acute
hepatitis. Four of five patients had radiological signs of
changes in the gallbladder with thickening of the wall and
oedema and one underwent later an elective cholecystect-
omy.
Conclusion
The outbreak of HAV in MSM Europe reached Iceland in the
summer 2017, emphasizing the importance of vaccination
in this risk group as recommended by the Icelandic Health
Authorities. The review of these cases indicate that changes
such as thickening of the gallbladder wall without gallstones
in patients with HAV are common. It is important to discrimi-
nate patients with these changes associated with HAV from
patients with acute acalculus cholecystitis.
European outbreak of Hepatitis A in Iceland in 2017.
Common radiological changes of the gallbladder
ENGLISH SUMMARY
Heimildir
Barst til blaðsins 8. mars 2018, samþykkt til birtingar 16. maí 2018.
1Landspitali, University Hospital of Iceland, 2University of Iceland, Faculty of Medicine, 3Directorate of Health.
Key words: Viral hepatitis A, European outbreak, men who have sex with men, acalculus cholecystitis.
Correspondence: Sif Ormarsdóttir, sifor@landspitali.is